Metatarsus adductus

Case contributed by Arif Abdul Majeed
Diagnosis certain

Presentation

Inward-pointing feet. Abnormal gait noticed by parents.

Patient Data

Age: 7 years
Gender: Female
x-ray

There is medial deviation of 1st metatarsal bone associated with medial displacement of the 1st and 2nd metatarsal bones relative to cuneiform bones. The 1st intermetatarsal angle is not widened.

Case Discussion

Metatarsus adductus is one of the most common congenital foot anomalies in infants. Etiology is not clear but thought to be due to breech positioning in later pregnancy leading to varus deformation of forefoot at the tarsometatarsal region of the foot. Approximately 50% of cases are bilateral. 

The condition is usually diagnosed in the 1st year, due to in-toeing. Femoral anteversion and Tibial torsion may be associated. Bleck classification (1983) is used to grade the severity. 

Both conservative and surgical options are available. Long term prognosis is good, with no foot dysfunction or pain.

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